Printable Consent Form

DENTURE

A denture is a removable appliance used to replace missing teeth and surrounding tissues. It can be a complete denture (replacing all teeth in an arch) or a partial denture (replacing some teeth and attached to remaining natural teeth with clasps or precision attachments).

DESCRIPTION OF TREATMENT

Impressions or digital scans are taken. A wax try-in may be done to evaluate fit, bite, and appearance. The final denture is fabricated in a lab. Multiple appointments are usually required for adjustments. Immediate dentures may be placed the same day as extractions.

BENEFITS

• Restores ability to chew and speak
• Improves appearance and facial support
• Replaces missing teeth in a non-invasive way (no surgery required for the denture itself)
• Removable for easy cleaning

RISKS AND POSSIBLE COMPLICATIONS

• Soreness, irritation, or ulcers on gums or tissues (especially initially)
• Difficulty adapting to speaking or chewing (learning curve)
• Loosening or poor retention over time as bone and gums change
• Need for relines, repairs, or replacement (typically every 5-7 years or as tissues change)
• Gagging or discomfort
• Allergic reaction to materials (rare)
• Accelerated bone loss in areas without teeth
• Clasps on partial dentures may cause wear or damage to natural teeth
• Dentures do not feel exactly like natural teeth and may require dietary adjustments

Dentures are not a perfect replacement for natural teeth. Proper care, regular adjustments, and professional maintenance are essential for success and oral health.

ALTERNATIVES

• Dental implants (fixed or implant-supported dentures)
• Fixed bridge (for limited missing teeth)
• No replacement (may lead to shifting teeth, bone loss, and bite problems)

PATIENT ACKNOWLEDGEMENT

• I understand that dentures are removable appliances and require time to adapt to.
• I agree to wear the denture as instructed and return for all adjustment and follow-up appointments.
• I understand the need for proper cleaning and storage of the denture.
• I consent to the use of any necessary impressions, adjustments, or relines.
• I understand that the fit and comfort of the denture may change over time due to natural changes in the mouth.

PATIENT / GUARDIAN ACKNOWLEDGEMENT AND CONSENT

I have read (or had read to me) and understand this consent form. I have had the opportunity to ask questions, and all of my questions have been answered to my satisfaction. I understand the risks, benefits, and alternatives of the proposed treatment. I voluntarily consent to the treatment described above.